Mentoring Application

Name*

First Last

Your business name*

Phone number:*

Mailing Address:*

Your Email Address:*

Business website URL: https://*

Social Media Links

Please tell me about your business. How long have you been in business? Whom do you serve, and how?*

How do you feel about your business?*

What is working well in your business?*

What challenges do you face in your business?*

What threshold are you ready to cross, in your business?*

How do you experience this growing edge?*

What brings you to me at this time? What would you like to accomplish by working with me?*

Is there anything else you’d like me to know about you?*

Finally, how did you connect with me? If you have taken a class or program with me, or worked with me privately in the past, please let me know that too.*

Check the box below that applies to you.*

I am applying for a single strategy session.
I am applying for three strategy sessions, to be completed in three months.
I am applying for a three-month mentoring immersion.

When would you like to begin your program?*

Now or as soon as an opening becomes available
Within the next three months

Please save a copy of your responses for your own records before submitting the form online.